Charlotte, NC
Preeti Kharel
Gauri Adhikari, MD
Pneumonia is an infection that inflames the air sacs in your lungs, making it hard for you to breathe. These air sacs can fill with fluid or pus, causing symptoms like coughing, fever, chills, and difficulty breathing. Pneumonia can be caused by bacteria, viruses, or fungi. In some cases, it follows a cold or the flu, but it can also develop on its own. [1]
Pneumonia can be classified based on where or how you get it. Community-acquired pneumonia (CAP) happens outside healthcare settings and is often caused by bacteria like Streptococcus pneumoniae that you can get from the community. Hospital-acquired pneumonia (HAP) develops 48 hours or more after hospital admission, while ventilator-associated pneumonia (VAP), a type of HAP, occurs after being on a ventilator. [2] Healthcare-associated pneumonia (HCAP) affects those recently in healthcare facilities like nursing homes or dialysis centers. Atypical pneumonia, caused by organisms like Mycoplasma pneumoniae, tends to have milder symptoms, while aspiration pneumonia occurs when you inhale food liquids or vomit into your lungs. [3, 4]
Bacteria like Streptococcus pneumoniae and Haemophilus influenzae are common causes of pneumonia. These infections typically occur when bacteria in the upper respiratory tract invade the lungs. [5]
Viruses such as influenza, respiratory syncytial virus (RSV), or COVID-19 can lead to pneumonia. Viral pneumonia is common in children and older adults and may weaken your immune system, increasing susceptibility to bacterial pneumonia. [5]
Certain fungi, especially in people with weakened immune systems, can cause pneumonia. For example, Histoplasma and Coccidioides fungi are linked to pneumonia in specific geographic regions. [6]
The very young (infants and toddlers) and the elderly (over 65) are more susceptible to pneumonia because their immune systems are either still developing or have become weaker over time. [7]
Chronic obstructive pulmonary disease (COPD), asthma, and chronic bronchitis increase the risk. These diseases reduce lung function, making it harder to clear infections from the lungs. [8]
Smoking damages your airways and weakens the lungs’ ability to clear out germs. Both current and former smokers have a higher chance of developing pneumonia. [9]
Inhaling food, liquids, or vomit into your lungs can lead to aspiration pneumonia. This is more common in people with swallowing difficulties or impaired reflexes, such as those who have had a stroke. [10]
If your immune system is weakened due to diseases like HIV/AIDS, cancer, or certain medications (like chemotherapy or immunosuppressants), you’re more vulnerable to infections, including pneumonia. [11]
Exposure to pollutants, secondhand smoke, or hazardous chemicals at work can raise your risk. Poor living conditions, such as overcrowded spaces and lack of ventilation, also increase the likelihood of infection. [12]
Pneumonia comes with several symptoms that can get worse if not treated early. Here are the main signs to look out for, explained simply:
A persistent cough is often one of the first signs of pneumonia. It may bring up thick mucus or phlegm, which can be clear, yellow, green, or even tinged with blood. This is your body’s way of trying to clear the infection from your lungs. [13]
Pneumonia frequently causes a high fever, sometimes exceeding 101°F (38.5°C). This may be accompanied by chills, sweating, and feeling unwell as your body fights off the infection. [14]
You might feel like you can’t catch your breath, even when resting. This can worsen with physical activity as your lungs struggle to supply enough oxygen due to inflammation and fluid buildup. [13]
Many people experience sharp or stabbing pain in their chest, especially when coughing or taking deep breaths. This is due to the inflamed tissues in and around your lungs. [14]
Pneumonia often makes you extremely tired and weak, even after simple activities. This happens because your body uses most of its energy to fight off the infection, leaving you drained. [14]
Older adults with pneumonia might feel confused or notice changes in their thinking, which can be an early sign of the illness. [14] Pneumonia in younger children may not always show the classic signs seen in adults. Instead, your child might vomit, have a fever, cough, or seem unusually tired and restless. Watch closely for specific signs of breathing problems, such as a bluish tone to their skin and lips, grunting noises while breathing, or the muscles between their ribs squeezing in with each breath. Rapid breathing and flaring nostrils with each breath are also key signs indicating your baby is struggling to breathe and may need immediate medical attention. [15]
Accurately diagnosing pneumonia is essential for effective treatment. Various tests help determine the presence, severity, and cause of the infection. Here are the key diagnostic methods used by healthcare professionals.
This simple, non-invasive test uses a small device clipped onto your finger to measure the oxygen levels in your blood. Pneumonia can lower oxygen levels, and this test helps assess how well your lungs are functioning. [16]
Blood tests can show if you have an infection by checking for elevated white blood cell counts or markers of inflammation. A blood culture may also be done to identify the specific bacteria causing the pneumonia, especially in severe cases. [16]
If you cough up mucus, your doctor may ask for a sample. A lab test can analyze this sample to identify the specific germ causing the infection, which helps guide treatment decisions. [16]
They are rapid and convenient diagnostic tools to identify the cause of pneumonia quickly. Rapid antigen tests detect viruses like influenza and RSV.. Rapid Polymerase chain reaction (PCR) tests find bacterial and viral infections in mucus or sputum samples. Lateral flow tests quickly detect infections like Streptococcus pneumoniae. [17]
A chest X-ray is often the first imaging test to confirm pneumonia. It helps identify the location and extent of the infection in your lungs. However, it might not reveal the cause, whether bacterial, viral, or fungal. [16]
In cases where the diagnosis is unclear, a CT scan provides detailed images of your lungs, offering a more precise view than a regular X-ray. It can show the extent of pneumonia and any complications, such as lung abscesses or pleural disorders. This is sometimes needed to rule out other lung conditions. [16]
If pneumonia doesn’t improve with initial treatment or your doctor suspects an unusual cause, they may perform a bronchoscopy. This procedure uses a thin, flexible tube with a camera to look inside your lungs and collect samples from the inside of your lungs to determine the cause of your pneumonia. [18]
If fluid builds up around your lungs, it is called pleural effusion. Your doctor might take this sample with a needle with the help of a procedure called thoracentesis. Analyzing this fluid can help identify the infection and its cause. [19]
Treating pneumonia involves a combination of medications, supportive care, and, in severe cases, medical procedures. The approach depends on the cause and severity of the infection. Here are the key treatment methods used to manage pneumonia effectively.
If your pneumonia is caused by bacteria, your doctor will prescribe antibiotics. These medications help kill the bacteria and speed up recovery. It’s important to take the entire course of antibiotics to eliminate all bacteria, even if you start feeling better. And if a virus is the cause of your pneumonia, you may need antiviral medications. These drugs can help manage symptoms and shorten the duration of the illness. [20]
If your oxygen levels are low, you may receive oxygen through nasal prongs, a facemask, or a special high-flow device. This helps deliver more oxygen to your lungs and can provide almost pure oxygen if needed. If you need more oxygen or are having trouble breathing, you may be given non-invasive ventilation to help your body receive it. This type of device uses a mask that can push the air into the congested lungs. If these methods don’t work, a tube connected to a machine might be inserted directly into your lungs to help supply the oxygen. During this time, your doctors will carefully manage the air pressure and volume to protect your lungs from further damage. [21]
Getting plenty of rest and staying hydrated is essential for recovery. Drinking fluids helps thin mucus, making it easier to expel, and rest allows your body to use energy for healing. It’s important to avoid any strenuous activities until you’re fully recovered. [14]
In severe cases of pneumonia, complications like pleural effusion or empyema can occur, where fluid or pus collects around the lungs. Chest tube drainage involves inserting a thin tube through the chest wall into the pleural space to drain this buildup. This procedure helps reduce pressure on the lungs, making breathing easier and lowering the risk of further infection. The chest tube placement is often guided by imaging techniques such as ultrasound or X-rays to ensure precision and effectiveness. [22]
When chest tube drainage is insufficient to manage complications, video-assisted thoracoscopic surgery (VATS) may be needed. This minimally invasive procedure involves small incisions through which a surgeon inserts a camera and specialized instruments to remove infected fluid, thickened pus, or damaged tissue from the pleural space. [23]
Pneumonia can lead to serious complications, especially if left untreated or if the immune system is weakened. These complications may require additional treatments and medical interventions. Here are some common complications associated with pneumonia.
Fluid can build up between the layers of tissue surrounding your lungs, making it harder to breathe. If the fluid gets infected (called empyema), it might need to be drained with a tube or surgery. [24]
This is a pocket of pus formed inside the lung. This can cause severe illness, high fever, and a bad-smelling cough. It is usually treated with antibiotics or, in rare cases, drained with a needle. [24]
The bacteria causing pneumonia can enter your bloodstream, spreading the infection to other parts of your body. This is a serious condition that may lead to sepsis, requiring immediate treatment in a hospital. [24]
Severe pneumonia can make it very difficult for your lungs to get enough oxygen into your blood. You may need oxygen therapy or even a ventilator to help you breathe. [24]
Pneumonia can stress your heart, sometimes causing irregular heartbeats or worsening existing heart conditions. In rare cases, it might lead to a heart attack. [25]
Some people may experience long-term breathing problems after severe pneumonia or develop conditions like bronchiectasis, where the airways become damaged and inflamed. [25]
Severe infections or low oxygen levels can sometimes harm your kidneys or liver, especially if you already have underlying health issues affecting these organs. [26]
Recovery from pneumonia can take time and varies depending on your age, overall health, and the severity of the illness. Most healthy adults with mild pneumonia recover within 1 to 3 weeks. Older adults, very young children, and those with chronic health conditions are at greater risk of complications, which can prolong recovery or lead to more severe outcomes. Regular follow-ups may be needed to monitor your progress and ensure your lungs heal properly. [27]
Preventing pneumonia involves taking steps to protect your lungs and overall health. Vaccinations are key, especially for children, older adults, and those with chronic conditions. Children need vaccines for Haemophilus influenzae (Hib) and Streptococcus pneumoniae. For adults, especially those over 65 or with health issues, pneumococcal and flu vaccines are recommended to help prevent pneumonia. Good hygiene also plays a huge role. You should wash your hands frequently, cover your mouth when coughing or sneezing, and avoid close contact with sick individuals. If you smoke, quitting can improve your lung health and lower your chances of getting pneumonia. Maintaining a healthy lifestyle with regular exercise, a balanced diet, and enough sleep can boost your immune system, helping your body fight infections more effectively. [28]
Prevention of aspiration is of utmost importance in people with neurological conditions or who are elderly to prevent pneumonia. Preventing aspiration involves simple yet effective steps to ensure food, liquids, or other substances do not enter your airway or lungs. Always sit upright at a 90-degree angle while eating or drinking, and stay in that position for at least 30 minutes after meals. [29]
Eat slowly, thoroughly chew food, and avoid talking or laughing. If you have swallowing difficulties, work with a speech therapist and use techniques like thickening liquids or pureeing food as needed. [30] For those who are bedridden, keeping the head of the bed elevated can help reduce the risk. Good oral hygiene is essential to prevent harmful mouth bacteria from aspirating into the lungs. Managing conditions like reflux and avoiding unnecessary sedatives can also lower aspiration risks. [30]
PK and GA are research assistants at eHealthyInfo and receive compensation for their work. No other conflicts of interest declared.
